Purpose
To evaluate the incidence of atypical pathology results in a series of 308 consecutive prostatectomies.
To correlate unusual histological results of prostatectomies with MRI findings, clinical presentation and patient outcome.
Methods and materials
Pathology results of 308 consecutive prostatectomies (2014-2018) were retrospectively evaluated. Prostate tumor variants and atypical findings in non-cancerous prostate tissue were selected for analysis.
Pathological data was obtained from the prostatectomy reports elaborated by a specialized urological pathologist. Medical records were evaluated for patient age, lower urinary tract obstructive symptoms, prostate specific antigen (PSA) serum levels (ng/ml), signs of dissemination and disease history. The pre-surgical biopsy reports were also compared with the prostatectomy pathology results.
MRI examinations were performed using a 1.5 Tesla (T) or...
Results
Atypical histological findings were found in 18 patients (5,8%): 14 tumor variants (4,5%) and 4 non-cancerous normal tissue (1,3%). These were 10 ductal adenocarcinomas (DA) (3,2%), 2 neuroendocrine (NE) tumors (0,6%), 1 rhabdomyosarcoma (RS) (0,3%) and 1 mucinous adenocarcinoma (MA) (0,3%). Granulomatous prostatitis (GP) was present in 3 (1%) patients. One (0,3%) patient presented amyloid deposits. Patients had a mean age of 59, with the lowest mean (53) associated with NE differentiation (Table 1).
Obstructive symptoms were reported only in one patient with DA and...
Conclusion
Atypical findings in prostatectomy specimen reports are rare, in our series less than 6%. DAis the most common tumorvariant[1] and is part of the epithelial group neoplasms[2]. DA is often mixed with the acinar-type [1] (in our series all were mixed-type). Only one of our patients presented with obstructive symptoms, even though previous reports state they are common. The high percentage of biochemical recurrence in our study may be explained by the worse prognosis for ductalcompared to acinar adenocarcinomas.
Even though most prostate adenocarcinomas show...
Personal information and conflict of interest
K. Pérez Alfonso; Barcelona/ES - Author at Bellvitge University Hospital D. Pittí Freiburghaus; Barcelona/ES - Author at Bellvitge University Hospital E. Merino Merino; Barcelona/ES - Author at Bellvitge University Hospital E. Condom Mundo; Barcelona/ES - nothing to disclose X. Bonet Punti; Barcelona/ES - nothing to disclose J. Garcia Bennet; Barcelona/ES - Author at Bellvitge University Hospital
References
[1]Humphrey, “Histological variants of prostatic carcinoma and their significance,”Histopathology. 2012.
[2]Humphreyet al., “The 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs—Part B: Prostate and Bladder Tumours,”Eur. Urol., vol. 70, no. 1, pp. 106–119, 2016.
[3]Parimiet al., “Neuroendocrine differentiation of prostate cancer: a review.,”Am. J. Clin. Exp. Urol., vol. 2, no. 4, pp. 273–85, 2014.
[4]He, “Diagnosis of prostatic neuroendocrine carcinoma: Two cases report and literature review,”World J.Radiol., vol. 7, no. 5, p. 104, 2015.
[5]Musseret al., “Adult prostate sarcoma: The...